Abstract

Introduction: Medical Humanities is the interface of health sciences and humanities and an emerging field of interest. Several papers have outlined the status of this field in the Asian region where a diversity of teaching and learning approaches have been used. We share developments initiated in a Sri Lankan medical school and discuss its relevance to the southern Asian region, especially in using arts in medical humanities.

Methods: Historical records, narratives, grey literature, and published resources were collated to describe the initiative in the Faculty of Medicine, University of Colombo.  The data was collected, synthesized and described especially in the context of the region.

Results: We observe a structured development of medical humanities in the curriculum. The novelty of the curriculum is that it evolving to include wider experiences from the visual and performance arts, in order to achieve the goal of promoting humaneness. The contents were locally developed, based on needs with an indigenous cultural bias giving rise to a unique southern Asian perspective of medical humanities.

Conclusion: There are diverse experiences and initiatives in medical humanities in Asian, and some are not captured in published literature. It is challenging to follow these diverse trends in different locations, share experiences and learn from each other, and place medical humanities in the regional and global maps of health professional education.

Abstract

Introduction: A deep understanding of physiology, physiopathology, pharmacology, and the management of pain is crucial for nurse anaesthetists to ensure the well-being of their patients. Thus, the teaching strategies should enhance the transition from acquiring the fundamental pain phenomena, to developing translational and critical thinking. The aim of the study is to determine if the flipped classroom that is considered an active learning approach is most effective compared to the traditional method in teaching pain management and if it improves students’ academic performance.

Methods: This study was quasi experimental, at a higher institute of nursing professions, among third-year anaesthesia resuscitation nursing students. participants were randomly allocated into either: the flipped classroom group where PBL was used (FG, n = 19), or the traditional lecture-based classroom group (TG, n = 19). The results and impact of the above approach were appreciated via the analysis of the summative assessment of the class group and from the questionnaire submitted to students.

Results: The present study revealed that in the midterm exam, the mean score of the flipped classroom group (14.0) which is significantly higher (p<0.01) than the traditional lecture group (11.9). Moreover, the standard deviation of this latter is slightly higher (2.41) which indicates scores far from the average. Also, a significant difference between the averages of the two approaches in favor of flipped classroom Group was revealed (p<0.01).

Conclusion: The assessment of student’s grades and their appreciation of both teaching approaches showed a preference for the PBL.

Keywords:           Flipped Classroom, Nursing Education, Pain Management, Problem-Based Learning

Abstract

Introduction: Dental materials science is one of the core courses for Malaysian undergraduate dental programmes, which has been primarily taught through a series of didactic lectures during the preclinical phase. In accordance with the newly revised national competency statement, Malaysian dental education is moving toward competency-based education, hence a reformation of the dental materials science curriculum is warranted.

Methods: Curriculum design including common teaching, learning and assessments methods for the Malaysian dental materials science were described and analysed. The common practices were reviewed and compared with latest national guidelines and literature.

Results: There is yet an initiative to establish a national curriculum for dental materials science. The use of traditional teaching strategies for this course also needs to be revamped from a teacher-centred to a student-centred approach. Furthermore, faculty members are facing significant challenges because the revamp requires them to explore cutting-edge pedagogical methods and develop appropriate learning opportunities, environments, resources, and assessments. Several recommendations are proposed, such as mapping the existing dental materials science curriculum to identify gaps, incorporating more hands-on sessions, implementing an integrated curriculum, introducing various formative and summative assessments, as well as recruiting faculty members with different areas of educational expertise.

Conclusion: It is hoped that this article offers a clearer pathway for Malaysian dental educators to pioneer new insight and transform the existing dental materials science curriculum.

COVID pandemic created worldwide disruptions to all services and had profound impact on training of health professionals, posing serious challenges to maintaining essential healthcare services. During the height of the pandemic, most of the undergraduate learners were prevented from clinical training sites, restricted intra, inter-institutional and overseas learning opportunities and in many institutions, there were termination of onsite learner-educator engagements (Ng et al., 2021; Renaud et al., 2021; Samarasekera et al., 2020). Less face to face, peer and faculty interactions and restricted mobility of learners led to some of them facing poor mental wellbeing and health issues.  The learning activities were mostly restricted to online platforms during the pandemic for students following health professional programs. During the latter part of the pandemic, however, there were changes when better preventive measures and immunisation were developed. The students were also allowed to provide limited care services to assist the practitioners who were providing critical services (Lau et al., 2021).

It has been almost three decades since Boyer (1990) introduced the concept of the Scholarship of Teaching and Learning (SoTL). In their own disciplines, faculty members are required to stay abreast of emerging knowledge and to contribute to the literature so that they advance their field through well-informed inquiry and disseminated work. Although they also have educational responsibilities, faculty are neither similarly motivated nor are they incentivised to participate in educational scholarship. Consequently, their efforts in this regard are often based on personal belief and opinion rather evidence and scientific inquiry. This problem persists despite a growing body of evidence that adopting sound instructional practices and pursuing scholarly work related to teaching, will increase the quality of the institution’s educational processes. In turn, this will enhance student learning and ultimately lead to better patient care. To achieve this end, teaching and learning must be scrutinised in terms of theory, methods, evidence, and outcomes. And faculty members who engage in teaching need to be rewarded for their participation in educational scholarship just as they are for efforts in their own disciplines.

Abstract

Introduction: Medical students have long provided informal, structured academic support for their peers in parallel with the institution’s formal curriculum, demonstrating a high degree of motivation and engagement for peer teaching. This qualitative descriptive study aimed to examine the perspectives of participants in a pilot peer teaching programme on the effectiveness and feasibility of adapting existing student-initiated peer bedside teaching into formal bedside teaching.

Methods: Study participants were senior medical students who were already providing self-initiated peer-led bedside clinical teaching, clinicians who co-taught bedside clinical skills teaching sessions with the peer teachers and junior students allocated to the bedside teaching sessions led by peer teachers.  Qualitative data were gathered via evaluation form, peer teacher and clinician interviews, as well as the observational field notes made by the research assistant who attended the teaching sessions as an independent observer.  Additionally, a single Likert-scale question on the evaluation form was used to rate teaching effectiveness.

Results: All three peer teachers, three clinicians and 12 students completed the interviews and/or questionnaires. The main themes identified were teaching effectiveness, teaching competency and feasibility. Teaching effectiveness related to the creation of a positive learning environment and a tailored approach. Teaching competency reflected confidence or doubts about peer-teaching, and feasibility subthemes comprised barriers and facilitators.

Conclusion: Students perceived peer teaching effectiveness to be comparable to clinicians’ teaching. Clinical peer teaching in the formal curriculum may be most feasible in a hybrid curriculum that includes both peer teaching and clinician-led teaching with structured training and coordinated timetabling.

Keywords:           Peer Teaching, Undergraduate Medical Education, Bedside Teaching, Medical Students

Abstract

Introduction: The practice of high-fidelity simulation-based medical education has become a popular small-group teaching modality across all spheres of clinical medicine. High-fidelity simulation (HFS) is now being increasingly used in the context of undergraduate medical education, but its superiority over traditional teaching methods is still not established. The main objective of this study was to analyse the effectiveness of HFS-based teaching over video-assisted lecture (VAL)-based teaching in the enhancement of knowledge for the management of tension pneumothorax among undergraduate medical students.

Methods: A cohort of 111 final-year undergraduate medical students were randomised for this study. The efficacy of HFS-based teaching (intervention group) and VAL-based teaching (control group), on the acquisition of knowledge, was assessed by single-best answer multiple choice questions (MCQ) tests in the first and eighth week of their surgery posting. Mean and standard deviation (SD) for the total score of MCQ assessments were used as outcome measures. ANCOVA was used to determine the difference in post-test MCQ marks between groups. The intragroup comparison of the pre-test and post-test MCQ scores was done by using paired t-test. The P-value was set at 0.05.

Results: The mean of post-test MCQ scores were significantly higher than the mean of pre-test MCQ scores in both groups. The mean pre-test and post-test MCQ scores in the intervention group were slightly more than those of the control group but not statistically significant.

Conclusion: There was a statistically significant enhancement of knowledge in both groups but the difference in knowledge enhancement between the groups was insignificant.

Keywords:           High-Fidelity Simulation, Video-Assisted Lecture, Simulation-Based Medical Education (SBME), Randomized Controlled Trial (RCT), Medical Education, Pre-test and Post-test Knowledge Assessments

Abstract

Introduction: This study aimed to examine the usefulness of Community Based-Education (CBE) and Interprofessional Education (IPE) to community health outcomes.

Methods: The design was a mixed-method study. Each small group worked together to identify family health problems, implement interventions, and evaluate the results. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was applied to compare students’ perceptions before and after the implementation. In addition, qualitative data were acquired from students’ comments on the questionnaire, interviews with community representatives, and FGDs with instructors at the end of the program.

Results: Three hundred and sixty-seven out of 465 students returned the completed paired questionnaire (78.9 % response rate). Paired t-test showed that student perception of responsibility slightly increased, whereas teamwork and collaboration, negative and positive professional identity decreased somewhat. However, most pre-post students’ responses already trended to the positive side (scales 4 and 5). Moreover, the Chi-square test showed that pre-post students’ confidence levels significantly increased. Most small groups of students successfully empowered the community to solve health problems. Students, instructors, and representatives of community members appreciated the program. However, several students felt their instructors were not motivated to mentor their tasks, and sometimes they had difficulty conducting home visits together. 

Conclusion: This study showed that the combination of CBE-IPE contributes to more favourable community health outcomes. However, it was challenging in several aspects of preparation, including highly motivated instructors. Nevertheless, pre and post-implementation students’ attitudes are still positive.

Keywords:        Interprofessional Education (IPE), Community Based Education (CBE), Health Profession Students, Readiness

Abstract

Introduction: The pandemic caused by the novel coronavirus (COVID-19) has produced dramatic changes in the learning environment for clinical practice in medical education, and the impact on medical students has been significant. However, few program evaluation studies involving professional identity, now emphasised in medical education, have compared current with pre-COVID-19 programs. Here, we compared the professional identity recognised by medical students in the years before and during COVID-19.

Methods: Medical students who participated in clinical practice were evaluated using the Japanese version of the Professional Self-Identity Questionnaire (PSIQ), a 9-item inventory rated using 7-point Likert scales. They answered on the first day of a 4-week clinical practice module within a community-based medical education (CBME) program and at graduation in 2018-2019 (pre-COVID-19 pandemic) and in 2019-2020 (during-COVID-19 pandemic). We compared the mean difference in total PSIQ score of the 2019-2020 students to those of the 2018-2019 students as a historical cohort using an unpaired t-test.

Results: Participants were 104 medical students in the 2018-2019 academic year and 92 in the 2019-2020 academic year. PSIQ was increased at graduation. Mean difference in total PSIQ score was statistically higher for the 2019-2020 students (13.5 ± 9.4) than for the 2018-2019 students (10.3 ± 8.1) (t =2.6, df =195, p = 0.01).

Conclusion: Although clinical practice was restricted by COVID-19, this had some positive impact on the strengthening of professional identity recognised by medical students. This finding may have been influenced by the imprinting of professional norms and changes in society.

Keywords:           Novel Coronavirus Infection, Professional Identity, Clinical Practice, Questionnaire Survey, Program Evaluation

Abstract

Introduction: Although medical research (MR) is constantly promoted, a global deficit of medical researchers has been noted. We aimed to explore the relationship among practice, perceptions, attitudes, barriers and motivation toward MR and its impacts on MR publication.

Methods: A cross-sectional study included 262 senior medical students and interns. An electronic, standardised Likert scale questionnaire was used to collect the data. Binary logistic regression was used to determine the odds ratio between characteristics and MR publication. Confirmatory factor analysis was used to confirm the loading factor of each question, and structural equation modeling (SEM) was used to investigate the relationship between latent variables and MR publication.

Results: Cronbach’s alpha revealed a good internal reliability of 0.93. The accumulated grade point average did not differ between those who had published and those who had not. MR presentations were strongly associated with MR publication. SEM showed that attitudes (0.71, p<0.001) and perceptions (0.27, p<0.001) had a direct effect on practices. Practices (0.49, p<0.001) and attitudes (0.30, p<0.001) had a direct effect on motivation, while motivation had a total effect = 0.36, p<0.001 on MR publication through MR presentation as a mediator.

Conclusion: Positive attitudes and perceptions might lead to positivity in the intention to practice MR, which would lead to motivation and finally increase the odds of MR publication. Different approaches to promote excitement and perceptions in MR learning should be encouraged by teachers and faculty members.

Keywords:           Medical Research, Students, Perceptions, Attitudes, Barriers, Motivation

Abstract

Introduction: This study aimed to compare the paediatric endocrinology curriculum across Southern Nigeria medical schools, using reports from learners. It also checked the learners’ perceptions about different learning patterns and competency in some expected core skills.

Methods: This mixed (quantitative and qualitative) study was conducted with 7 medical schools in Southern Nigeria. A multi-staged randomized selection of schools and respondents, was adopted for a focus group discussion (FGD), and the information derived was used to develop a semi-structured questionnaire, which 314 doctors submitted. The FGD discussed rotation patterns, completion rates of topics and perceptions for some skills. These themes were included in the forms for general survey, and Likert scale was used to assess competency in skills. Data generated was analysed using statistical package for social sciences, SPSS 24, and p values < 0.05 were considered significant

Results: Lectures and topics had various completion rates, 42.6% – 98%, highest being “diabetes mellitus”. Endocrinology rotation was completed by 58.6% of respondents, and 58 – 78 % perceived competency in growth measurement and charting. Significantly more learners, 46.6% who had staggered posting got correct matching of Tanner staging, versus learners who had block posting, 33.3%, p = 0.018.

Conclusion: Respondents reported high variability in the implementation of the recommended guidelines for paediatric endocrinology curriculum between schools in Southern Nigeria. Variabilities were in the courses’ completion, learners’ skills exposure and how much hands-on were allowed in various skills acquisitions. This variability will hamper the core objectives of human capital development should the trend continue.

Keywords:          Paediatric Endocrinology Curriculum, Perception, Compliance, Completion Rate, Learners

Abstract

Introduction: There are various difficulties in treating foreign patients; however, the existing educational programs are still insufficient for addressing this issue. The purpose of this study is to investigate what difficulties are encountered in the treatment of foreigners in emergency departments, and to create scenarios for simulation-based education using real-life cases.

Methods: A cross-sectional anonymous survey to 457 emergency departments was conducted in 2018. Additionally, we conducted a survey of 46 foreign residents who had visited hospitals for treatment in Japan. The data was analysed quantitatively, and the narrative responses were thematically analysed.

Results: Of the 141 hospitals that responded (response rate: 30.9%), 136 (96.5%) answered that they had treated foreign patients. There were 51 and 66 cases with cultural and linguistic difficulties, respectively. In the qualitative analysis, different ideas/beliefs towards treatments or examinations (51.0%) and communication with non-English speaking patients (65.2%) were most common categories in the cases with cultural and linguistic difficulties, respectively. The survey of 46 foreign residents on the surprising aspects of Japanese healthcare showed, 14% mentioned difference in treatment plans between own country and Japan, 12% each mentioned a lack of explanation by medical staff, and a lack of privacy in the examination room. Based on the survey results, we created 2 scenarios of simulation.

Conclusions: Scenarios of simulation-based education using real-life cases may be effective materials for cultivating cultural awareness of medical staff.

Keywords:       Cultural Awareness, Cultural Humility, Emergency Department, Foreign Patients, Simulation-based Education

Abstract

Introduction: Workplace contexts, including political and sociocultural systems influence health professions’ perception and experience of ethical issues. Although established health ethics principles are relevant guiding values, they may be experienced and interpreted differently within different health contexts. How should ethics education account for this? This paper presents ethical dilemmas and concerns encountered by physiotherapists practicing in Singapore and discusses the implications for ethics education.

Methods: Qualitative methods informed by interpretivism and phenomenology were employed. In-depth interviews with 42 physiotherapists from different workplace settings in Singapore were conducted. Participants described everyday ethical challenges they encountered. Inductive content analysis was used to analyse the interview transcript data.

Results: Ethical issues occurred within and across three spheres of ethics:  micro, meso and macro. Ethical issues at the micro sphere centered around physiotherapist-patient relationships, interactions with colleagues, and therapists’ feelings of moral distress. In the meso sphere, ethical challenges related to influences arising from the organizational resources or systems. In the macro sphere, ethical challenges developed or were influenced by sociocultural, religious, economic, and political factors.

Conclusion: The findings reflect current literature indicating that context can influence ethical situations, as experienced and perceived by physiotherapists in their unique settings. Such empirical data might inform the development of ethics curricula to ensure that universal ethical principles are situated within the realities of clinical practice. Locally relevant and realistic ethical case studies will better enable students to recognise and address these situations.

Keywords:           Ethics, Physiotherapy, Health Professions Education, Ethics Education, Asian Context, Singapore, Healthcare Principles, Health Ethics Principles

Abstract

Introduction: Global medical and healthcare education systems are increasingly adopting team-based learning (TBL). TBL is an interactive teaching programme for improving the performance, clinical knowledge, and communication skills of students. The aim of this study is to report the learning experience and satisfaction of participants with the TBL programme in the preclinical years of the Faculty of Medicine, Chiang Mai University.

Methods: Following the implementation of TBL in the academic year 2022, we asked 387 preclinical medical students, consisting of 222 Year 2 and 165 Year 3 medical students who attended the TBL class to voluntarily complete a self-assessment survey.

Results: Overall, 95.35% of the students were satisfied with the structure of the TBL course and agreed to attend the next TBL class. The overall satisfaction score was also high (4.44 ± 0.627). In addition, the students strongly agreed that the TBL programme improved their communication skills (4.50 ± 0.796), learning improvement (4.41 ± 0.781), and enthusiasm for learning (4.46 ± 0.795).

Conclusion: The survey findings indicated that students valued TBL-based learning since it enabled them to collaborate and embrace learning while perhaps enhancing their study abilities. However, since this is a pilot study, further investigations are warranted.

Keywords:           Team-based Learning, Small Group Interaction, Medical Education, Implementation

Abstract

Introduction: Examiner training is essential to ensure the trustworthiness of the examination process and results. The Anaesthesiology examiners’ training programme to standardise examination techniques and standards across seniority, subspecialty, and institutions was developed using McLean’s adaptation of Kern’s framework.

Methods: The programme was delivered through an online platform due to pandemic constraints. Key focus areas were Performance Dimension Training (PDT), Form-of-Reference Training (FORT) and factors affecting validity. Training methods included interactive lectures, facilitated discussions and experiential learning sessions using the rubrics created for the viva examination. The programme effectiveness was measured using the Kirkpatrick model for programme evaluation.

Results: Seven out of eleven participants rated the programme content as useful and relevant. Four participants showed improvement in the post-test, when compared to the pre-test. Five participants reported behavioural changes during the examination, either during the preparation or conduct of the examination.  Factors that contributed to this intervention’s effectiveness were identified through the MOAC (motivation, opportunities, abilities, and communality) model.

Conclusion: Though not all examiners attended the training session, all were committed to a fairer and transparent examination and motivated to ensure ease of the process. The success of any faculty development programme must be defined and the factors affecting it must be identified to ensure engagement and sustainability of the programme.

Keywords:           Medical Education, Health Profession Education, Examiner Training, Faculty Development, Assessment, MOAC Model, Programme Evaluation

Abstract

Introduction: Increases in vaccine hesitancy continue to threaten the landscape of public health. Literature provides recommendations for vaccine communication and highlights the importance of patient trust, yet few studies have examined medical student perspectives on vaccine hesitancy in clinical settings. Therefore, we aimed to explore medical student experiences encountering vaccine hesitancy, mistrust, and personal biases, with the goal of informing medical student education.

Methods: A health disparities course including simulated clinical scenarios required students to complete a written reflection. We sorted reflections written in 2014-2016 to identify common topics and used inductive thematic analysis to identify themes relevant to vaccine hesitancy by group consensus.

Results: Our sample included 84 de-identified essays sorted into three non-exclusive topics: vaccine hesitancy (n=42), mistrust (n=34), and personal bias (n=39). We identified four themes within medical students’ reflections: 1) Building a Relationship, including emphasis on patient-centred approaches; 2) Preparedness and Need to Prepare for Future Encounters, including highlighting gaps in medical education; 3) Reactions to Encountering Hesitant Patients, including frustration; 4) Insights for Providing Information and Developing a Plan with Hesitant Patients, including approaches to presenting knowledge. 

Conclusion: Reflections in the context of simulated encounters and discussion are useful in students identifying their preparedness for vaccine discussion with patients. Student reflections can assist educators in identifying missing educational frameworks for particular scenarios such as vaccine hesitancy. Without a structured framework regarding addressing vaccine hesitancy, students draw upon other skills that may contradict recommended practices.

Keywords:           Medical Education, Vaccine Hesitancy, Reflective Writing, Bias, Mistrust

Abstract

Introduction: This study was performed to understand how fixed clinical teams affected informal learning in Emergency Medicine Residents. Better understanding the effects of team dynamics on informal learning may help to optimise learning and improve performance.

Methods: From 8^th February 2020 till 27^th September 2020, the Singapore General Hospital Emergency Department adopted a fixed team system. Zoom interviews were carried out amongst Emergency Medicine Residents who worked in the fixed team system using a semi-structured iterative interview guide. A qualitative content analysis was used for this exploratory study. The interviews were transcribed verbatim, anonymised and coding via template analysis performed. Data collection and analysis were performed until data sufficiency.

Results: The themes identified centred around relationship dynamics, team composition and motivation for learning. The first was how improved relationships led to improved trust, communications and camaraderie among team members. This improved peer learning and clinical supervision and provided a more personalised learning experience. A balanced team composition allowed learners to be exposed to experts in various subspecialties. Finally, there was an initial increase in motivation, followed by a decrease with time.

Conclusion: In postgraduate medical education, working in a fixed team system with balanced members had positive effects on informal learning by strengthening relationships and communications.

Keywords:           Informal Learning, Workplace Learning, Fixed Teams, Medical Education, Postgraduate

Abstract

Introduction: The global COVID-19 pandemic had greatly affected the delivery of medical education, where institutions had to convert to remote learning almost immediately. This study aimed to measure undergraduate medical students’ readiness and factors associated with readiness for remote learning.

Methods: A cross-sectional quantitative study was conducted amongst undergraduate medical students using the Blended Learning Readiness Engagement Questionnaire, during the pandemic where lessons had to be delivered fully online in 2020. 

Results: 329 students participated in the study. Mean scores for remote learning readiness were 3.61/4.00 (technology availability), 3.60 (technology skills), 3.50 (technology usage), 3.35 (computer and internet efficacy), and 3.03 (self-directed learning). Male students appeared more ready for remote learning than females, in the dimensions of self-directed learning and computer and internet efficacy. Students in the pre-clinical years showed a lower level of readiness in the technology availability domain compared to clinical students. The lowest score however was in the self-directed learning dimension regardless of the students’ year of studies.

Conclusion: The pandemic had created a paradigm shift in the delivery of the medical program which is likely to remain despite resumption of daily activities post-pandemic. Support for student readiness in transition from instructor-driven learning models to self-directed learning models is crucial and requires attention by institutions of higher learning. Exploring methods to improve self-directed learning and increase availability of technology and conducting sessions to improve computer and internet efficacy can be considered in the early stages of pre-clinical years to ensure equitable access for all students.

Keywords:            Remote Learning, Student’s Readiness, Medical Education

Abstract

Introduction: Disruptions of the postgraduate (PG) teaching programmes by COVID-19 have encouraged a transition to virtual methods of content delivery. This provided an impetus to evaluate the coverage of key learning goals by a pre-existing PG didactic programme in an Obstetrics and Gynaecology Specialty Training Programme. We describe a three-phase audit methodology that was developed for this

Methods: We performed a retrospective audit of the PG programme conducted by the Department of Obstetrics and Gynaecology at National University Hospital, Singapore between January and December 2019 utilising a ten-step Training Needs Analysis (TNA). Content of each session was reviewed and mapped against components of the 15 core Knowledge Areas (KA) of the Royal College of Obstetrics & Gynaecology membership (MRCOG) examination syllabus.

Results: Out of 71 PG sessions, there was a 64.9% coverage of the MRCOG syllabus. Four out of the 15 KAs were inadequately covered, achieving less than 50% of knowledge requirements. More procedural KAs such as “Gynaecological Problems” and those related to labour were poorly (less than 30%) covered. Following the audit, these identified gaps were addressed with targeted strategies.

Conclusion: Our audit demonstrated that our pre-pandemic PG programme poorly covered core educational objectives i.e. the MRCOG syllabus, and required a systematic realignment. The COVID-19 pandemic, while disruptive to our PG programme, created an opportunity to analyse our training needs and revamp our virtual PG programme.

Keywords:        Medical Education; Residency; Postgraduate Education; Obstetrics and Gynaecology; Training Needs Analysis; COVID-19; Auditing Medical Education

Abstract

Introduction: Digital Badges have emerged as an alternative credentialing mechanism in higher education. They have data embedded in them and can be displayed online. Research in education suggests that they can facilitate student motivation and engagement. The authors introduced digital badges in a Psychiatry module in an Irish University. Completion of clinical tasks during the student’s clinical placements, which were previously recorded on a paper logbook, now triggers digital badges. The hope was to increase students’ engagement with the learning and assessment requirements of the module.

Methods: The badges – gold, silver and bronze level – were acquired on completion of specific clinical tasks and an MCQ. This was done online and student progress was monitored remotely. Data was collected from the students at the end of the module using a questionnaire adapted from validated questionnaires used in educational research.

Results: The response rate was 68%. 64% of students reported that badges helped them achieve learning outcomes. 68% agreed that digital badges helped them to meet the assessment requirements. 61% thought badges helped them to understand their performance. 61% were in favour of the continuing use of badges. Qualitative comments suggested that badges should contribute to a higher proportion of the summative mark, and identified that badges helped students to structure their work.

Conclusions: The findings are in keeping with the literature in that engagement and motivation have been facilitated. Further evaluation is required but the use of badges as an educational tool is promising.

Keywords:           Medical Education, Digital Badges, Students’ Engagement, Continuous Assessment Gamification, Health Profession Education

Abstract

Introduction: Perceptions towards the working and learning environment as well as coping mechanisms have been studied across different healthcare sectors. They have shown to reduce stress and burnout. However, perceptions of the work environment in the Emergency Department (ED) setting have not been studied in depth. The literature surrounding coping mechanisms also mostly focuses on their impacts rather than the mechanisms utilised. In addition, these were often investigated using surveys. This study aimed to use a phenomenological approach to explore the perceptions and coping strategies of junior doctors working in a paediatric ED.

Methods: Sixteen junior doctors working in the Paediatric ED were recruited. Semi-structured interviews were conducted after conducting literature reviews. Data was collected until saturation point. All interviews were recorded and transcribed verbatim manually and subsequently analysed.

Results: The greatest fears of junior doctors starting their paediatric emergency posting were lack of knowledge due to inexperience in the subspecialty; fear of the work environment due to unfamiliarity as well as workload and the intrinsic high-stress environment. The main coping strategies were ensuring clinical safety, obtaining psychosocial support from loved ones and colleagues, and placing focus on spirituality and wellbeing.

Conclusion: In this study, the perceptions and coping strategies of the junior doctors in the Paediatric ED were explored. The findings from this study will help to structure and improve the support given to future junior doctors who rotate to the department as well as better orientate them to allay their pre-conceived notions.

Keywords:          Coping Behaviours, Perceptions, Paediatric Emergency Department, Stressors, Interviews

Abstract

Introduction: A series of workshops was held early in our MD curriculum redesign with two aims: gaining stakeholder input to curriculum direction and design; engaging colleagues in the curriculum development process.

Methods: Workshops format included rationale for change and small-group discussions on three questions: (1) Future challenges in healthcare? (2) our current strengths? (3) Future graduate attributes? Small-group discussions were audio-recorded, transcribed and fieldnotes kept and thematically analysed. We conducted a literature review looking at best practice and exemplar medical programs globally.

Results: Forty-seven workshops were held across 17 sites with more than 1000 people participating and 100 written submissions received. Analysis showed alignment between data from workshops, written submissions and the literature review.

The commitment of our medical community to the education of future doctors and to healthcare was universally evident.

Six roles of a well-rounded doctor emerged from the data: (1) Safe and effective clinicians – clinically capable, person-centered with sound clinical judgement; (2) Critical thinkers, scientists and scholars with a thorough understanding of the social and scientific basis of medicine, to support clinical decision making; (3) Kind and compassionate professionals – sensitive, responsive, communicate clearly and act with integrity; (4) Partners and team players who collaborate effectively and show leadership in clinical care, education and research; (5) Dynamic learners and educators – adaptable and committed to lifelong learning; and (6) Advocates for health improvement – able to positively and responsibly impact the health of individuals, communities and populations

Conclusion: Deliberate stakeholder engagement implemented from the start of a major medical curriculum renewal is helpful in facilitating change management.

Keywords:            Medical Education, Medical Curriculum, Stakeholder Engagement, Collaboration

Portfolio has been used since the early 15^th century to showcase designs, and folders of work for architectural, artistic and financial purposes. Though the method of delivering a portfolio has shifted over the years from a “folder of loose papers” to “electronic portfolios” with the advent of technology; the crux of portfolios has remained the same. The purpose of portfolio to allow for a personalised approach for each individual to showcase their knowledge, professional values and skills has remained constant over the past hundreds of years. (Buckley et al., 2009) The usage of portfolio in medical education has been thought to give students more responsibilities for their own learning and development and aid in stimulating the reflective thought process (Driessen et al., 2003). Moreover, portfolio has been considered being a more holistic approach to assessing students in medicine, which allows a broader method in assessment rather than a ‘snap-shot’ examination (Van Tartwijk & Driessen, 2009).

Abstract

Introduction: Introduction to Health Profession (IHP) was designed to teach first-year medical students the importance of self-directed learning, accountability, and teamwork in healthcare. Due to the COVID 19 pandemic, the course was delivered virtually, incorporating elements of gamification.

Methods: Gamification features included collaborative teamwork to simulate and record the roleplay for assignments based on crisis management scenarios. The syllabus involves knowledge checks to promote self-directed learning and personal accountability as well as online questionnaires to identify personality traits followed by discussion. Games like Chinese whispers and charades were introduced to identify listening skills. Additional gamification features include progress mechanics for collecting badges upon successful completion of knowledge checks / assessments and completing collaborative teamwork activities.

Results: Results from the descriptive study on the educational usefulness of the IHP module was found to be satisfactory. The feedback was encouraging as >95% of students gave positive feedback that the IHP activities enabled them to understand the value of teamwork, effective communication, professional behavior and enabled them to be resilient and adaptable. 92% agreed that the IHP activities helped to make connections and network with their peers during the pandemic

Conclusion: Gamification of IHP course was successful in terms of practicality and usefulness in promoting communication, collaborative work, experiential learning, and teamwork. Students were empowered to take charge of their own learning of both content and development of interpersonal skills and teamwork through gamification. The isolation caused by the pandemic was alleviated by the networking that occurred during collaborative group activities.

Keywords:           Gamification, Self-directed Learning, Collaborative Learning

Abstract

Introduction: Summative assessments play a major role in shaping the student’s learning. There is little literature available on validity of summative assessment question papers in Forensic Medicine & Toxicology. This study analyses 30 question papers from 6 reputed universities for content validity.

Methods: A retrospective cross-sectional record-based observational study was conducted where 30 university summative question papers in Forensic Medicine & Toxicology from 6 universities across India were evaluated for content validity. The learning domain assessed, the type of questions asked, and sampling of the content was compared and presented in the results.

Results: From the results of the study, it was noted that 80% weightage was allotted to recall in most papers and only one paper tested for application. 70 to 80% of the marks were allotted to Forensic Pathology leading to disproportionate sampling. Core areas in Toxicology and Medical Jurisprudence were sparsely assessed. 

Conclusion: The content validity of the summative question papers in Forensic Medicine and Toxicology was unsatisfactory, emphasising the need for evaluation of the clarity and efficacy of the blueprints being used by the universities. Faculty training to motivate and influence a change in the mindset is necessary to bring about a course correction.

Keywords:           Forensic Medicine & Toxicology, Summative Assessments, University Assessments, Blueprint, Content Validity, Learning Domains

Abstract

Introduction: During the era of COVID-19 pandemic, online learning has become more prevalent as it was the most available option for higher education training which has been a challenging experience for the students and the lecturers especially in the medical and health sciences training.  The study was conducted to determine the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic.

Methods: A cross sectional study was conducted to clinical year medical students at University Tunku Abdul Rahman. The validated Online Learning Environment Survey (OLES) was used as a tool to conduct the study.

Results: Total 84 clinical year students participated in the study. Among four domains of OLES questionnaire, the domain; “Support of online learning” had the highest mean perception scores, 4.15 (0.55), followed by “Usability of online learning tools” 3.89 (0.82), and “Quality of Learning; 3.80 (0.68) and the domain “Enjoyment” was the lowest mean perception scores 3.48 (1.08). Most of the students (52.4%) rated the overall satisfaction of online teaching experiences “Very good” while (13.1) % rated “Excellent”.

Conclusion: In conclusion, the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic were satisfactory although there were challenging online learning experiences during the pandemic. It was recommended to include qualitative method in future studies to provide more useful in-depth information regarding online learning environment.

Keywords:            Online Learning Environment, Perceptions, Medical Students, Malaysia, COVID-19

Health Professional Education has considerably evolved over the years. Traditional classroom teaching has shifted to blended learning modalities, and clinical teaching has embraced virtual reality and simulation-based learning.

Education is poised for another major change with the development of artificial intelligence (AI) models that can emulate human-like intelligent behaviour, particularly in the field of large language models (LLM) that are capable of generating text in response to user input. There has been remarkable progress in the development of these models, with each iteration having an increasing ability to generate human-like responses to user input.

Abstract

Introduction: Didactic pedagogy and passive learning in bioethics and medical humanities teaching are ineffective in engaging students and gauging learning interests. As a result, medical students are unaware of why and how bioethics and medical humanities relate to their learning and thus prioritising acquiring clinical knowledge in their medical education.

Methods: This project involves a teacher-student collaboration to develop a teaching approach, which bridges historical events and contemporary issues, acknowledging how ethics and humanities are interwoven in clinical and everyday life. The objectives are to (1) highlight landmark historical events in bioethics and medical humanities and (2) recognise the evolving nature of values and social norms that inform current practice.

Results: The three activities include the use of historical narratives, annual newsletter publications, and social media to augment didactic classroom teaching and learning. Video narratives of landmark events in bioethics were developed to strengthen historical knowledge and encourage self-reflection. The newsletter invited students to write about any topic in bioethics and medical humanities and enabled them to experience a peer-review process. It allowed students to critically appraise everyday issues. Social media engagement via Instagram offered a flexible and informal medium to diversify the traditional bioethics content taught in the classroom. The advantages and obstacles of each element are discussed.

Conclusion: A holistic approach using historical narratives, newsletters, and social media engages students’ learning and allows students to become conscious of how past events shape the present.

Keywords:          Bioethics, Medical Ethics, Medical Humanities, Education, History, Curriculum Development, Social Media, Student as Partner, Newsletter

Abstract

Introduction: For all clinical providers in healthcare, decision-making is a critical feature of everything they do. Every day physicians engage in clinical decision-making where knowledge, evidence, experience, and interpretation of clinical data are used to produce decisions, yet, it is fair to say that most do not have an explicit insight or understanding of this complex process. In particular, few will have training in teaching and assessing the cognitive and affective factors that underlie clinical decision-making.

Methods: To foster an increased awareness and understanding of these factors, the Dalhousie Critical Thinking Program was established with the mandate to develop and deliver curriculum for critical thinking in the 4-year undergraduate program. To assist teaching faculty with the goal and objectives of the program, the Teaching and Assessing Critical Thinking Program (TACT) was introduced.

Results: Using the dual process model as a platform for decision-making, this program introduces general principles of critical thinking and provides tools to teach learners how to strengthen their critical thinking skills. To offer flexible learning, an online approach was chosen for delivery of the program.

Conclusion: To date, we have offered eleven iterations of Part 1 to a total of 261 participants and six iterations of Part 2 to a total of 89 participants. Evaluations show the online approach to content delivery was well received and the content to be of practical use.

Keywords:     Critical Thinking, Clinical Decision-Making, Faculty Development, Asynchronous Learning

I. INTRODUCTION

The world will never be the same after the COVID-19 pandemic. Education has had to evolve. Evaluation of cognitive skills is still achieved by written examinations administered through learning management systems. However, an integral part of evaluation, the Objective Structured Clinical Examination (OSCE), which assesses the students’ ability to obtain, communicate information, perform physical examination, diagnose, and solve problems, could not be given due to COVID-19 restrictions.

I. INTRODUCTION

International medical electives are a central component of the academic curriculum in many medical schools and universities worldwide (Storz, 2022). As short-term clinical immersion experiences, abroad electives are essential in connecting medical faculties and academic hospitals around the globe. They foster cross-cultural exchange, medical skill training, as well as professional identity formation (Imafuku et al., 2021; Storz, 2022). From a global health perspective, abroad electives provide medical students with an opportunity to gain a better understanding of healthcare and medical education in an international context.

Abstract

Introduction: In the first weeks of medical school, students learn fundamental cell biology in a series of lectures taught by five lecturers, followed by a mass tutorial session.  In this exploratory study, we examined students’ perceptions of the mass tutorial session over two academic years to find out if they viewed the tutorials differently after minor tweaks were introduced.

Methods: Reflective questions were posted to the undergraduate Year 1 Medical students at the end of each mass tutorial session in 2019 and 2020. Content analysis was conducted on students’ anonymous responses, using each response as the unit of analysis. The responses were categorised under the learning objectives, with responses coded under multiple categories where appropriate. The distribution of the counts from responses in 2019 and 2020 was compared, and the tutorial slides used over the two years were reviewed in conjunction with students’ perceptions to identify changes.

Results:  In 2019, we collected 122 responses which coded into 127 unique counts, while in 2020, 119 responses coded into 143 unique counts. Compared to 2019, we noted increases in the percentage of counts under “Link concepts” and “Apply knowledge”, with concomitant decreases in percentage of counts in “Recall contents”. We also found that the 2020 tutorial contained additional slides, including a summary slide and lecture slides in their explanations of answers to the tutorial questions.  

Conclusion: Minor tweaks in the tutorial presentation could improve students’ perceptions of our mass tutorials.

Keywords:          Mass Tutorials, Students’ Reflections, Apply Knowledge, Link Concepts, Minor Tweaks

Abstract

Introduction: Coaching has gained acceptance in the education field as a way to enable learners to achieve their fullest potential. In the endeavor to set up a coaching ecosystem in our university, we started by equipping our educators with fundamental coaching skills and techniques. Our training workshop, Coaching As An SIT Educator, covers the key coaching competencies and is highly practice focused. Participants get hands-on skills practice using contextualised scenarios that are based on realistic academic, workplace and clinical placement settings.

Methods: To address concerns on time-effectiveness, we adopt a solution-focused approach to coaching. We want to create a mindset shift for educators, from subject experts providing advice and solutions, to coaches asking powerful coaching questions that help students make discoveries and work towards their goals. We encourage our educators to engage students holistically by finding coachable moments in their daily student interactions.

Results: Competency-based assessments are conducted to determine achievement of the learning outcomes, articulated by the knowledge, attitude, and demonstration of coaching skills with students. Assessments consist of a reflection, multiple-choice question (MCQ) quiz, and scenario-based coaching role plays. Participants achieved the learning outcomes as demonstrated from the assessments.

Conclusion: The coach training workshop is the major pillar of our coaching initiative. Beyond the workshop, ongoing coaching development is supported through other activities and resources, including community of practice, coaching circle and knowledge repository. Opportunities for continuous learning and conversation platforms for sharing coaching experiences are part of the growing coaching ecosystem at SIT.

Keywords:         Assessments, Coaching Competencies, Coaching Conversations, Coaching Ecosystem, Coachable Moments, Faculty Development, Feedback, Holistic Development, Solution-Focused

I. INTRODUCTION

Increasing attention has been given to the role of medical humanities in both clinical care as well as in medical education. Medical humanities is defined as an “interdisciplinary perspective that draws on both creative and intellectual methodological aspects of disciplines such as anthropology, art, bioethics, drama and film, history, literature, music, philosophy, psychology, and sociology” (Hoang et al., 2022). 

It was found that the excess mortality rate for U.S. physicians was considerably lower during the COVID-19 pandemic than in the general population, but more physicians died than expected when compared to pre-pandemic levels. These results suggest that appropriate infection control measures can reduce mortality; however, additional measures are needed.

During the COVID-19 pandemic, there have been many reports of burnout among healthcare professionals (HCPs). Although no causal relationship has been established, it is acknowledged that it would be difficult to pay attention to mental health issues and the creation of a healthy work environment during a pandemic.

Abstract

Introduction: An evaluation of the online medical course was conducted to assess student readiness, engagement, and satisfaction at the San Beda University College of Medicine in Manila during the COVID-19 pandemic.

Methodology: A convergent mixed methods approach was done with a quantitative online survey and a qualitative thematic analysis of focus group discussions (FGD) with medical students. A total of 440 students participated in the survey while 20 students participated in the FGDs.

Results: The medical students were sufficiently equipped with computers and internet connections that allowed them to access the online medical course from their homes. The 5 themes identified during the study that were relevant to education were: Student readiness for online learning, Learning Management System (LMS) and internet connectivity, teaching and learning activities, the value of engagements, and teaching effectiveness of the faculty. The combined quantitative and qualitative analysis revealed vital issues that affect student learning. This included the need for students to interact with fellow students and to be engaged with their faculty. The issues that affect teaching included the need for continuing faculty training and management skills in delivering the full online course.

Conclusion: The success of online education rests heavily on the interactions of the students, the teachers, and the knowledge. Student interactions, managerial and skills training for the faculty, and providing students with a mix of synchronous and asynchronous activities are the most effective means to ensure the effective delivery of online medical courses.

Keywords:       Medical Curricular Revision, Formative Evaluation, Student Engagement, Synchronous and Asynchronous Online Learning, Cognitive Overload

Abstract

Introduction: The aim of this short communication is to examine the journey of scholarship in health professions education (HPE).

Methods: We will focus on tangible small steps to start, sustain, and succeed along this journey. Through a proposed innovation in scholarship – micro-scholarship – we will describe how this is similar to and an extension of bite-size or micro-learning, and workplace micro-practice related to just-in-time (JiT) learning settings.

Results: We will demonstrate how the small steps for generating and engaging with micro-content can be similarly applied to micro-scholarship. Then, progressive and iterative refinement of output and practice of micro-scholarship can be combined and result in macro-scholarship after cycles of public engagement for final digital or print publication. This stepwise approach creates an accessible, sustainable strategy to achieve success as a scholar in HPE. We will elaborate on micro, macro, and meta matters and celebrate how these small steps encourage and allow broad participation in the creation, critique, and progressive refinement of scholarship.

Conclusion: Small, sustainable, steps leads to success as a scholar in Health Professions Education – Micro (macro and meta) matters.

Keywords:      Micro-Scholarship, Micro-Learning, Just-In-Time (JiT) Learning, Community of Practice (CoP), Technology, Network Effects, Post-Publication Peer Review (PPPR)

A program director of a one-year-old Singapore surgical residency programme reads a publication about a new model of feedback. The paper describes how a US medical school successfully trialled and implemented this new feedback model. Excited, she then tries to implement this new model in her residency programme. Unfortunately, this fails to change faculty and resident behaviour, with disgruntled faculty and residents, and poor take-up by the various surgical departments within her programme. Disappointed, she stops using the new feedback model after a year.

What happened? Why would an educational intervention about feedback, published as part of Scholarship of Teaching and Learning (SoTL) (Steinert, 2017), and successfully implemented in a US medical school, fail to take root in a Singapore surgical residency programme? Might failure to consider context have contributed?  A review of the publication showed that while descriptions of the feedback model and the educational outcomes were rich, descriptions of the medical school environment and the broader educational context of the US were sparse.

I. INTRODUCTION

Airway management is critical for any anaesthetist. The Coronavirus Disease 2019 (COVID-19) pandemic has brought such skills to the forefront over the last three years. Yet, the outbreak has also disrupted traditional methods of airway skills training and limited the chances of in-person workshops and conferences due to social distancing requirements and demanding manpower needs. To lower the incidence of airway-related morbidity (Joffe et al., 2019), regular and effective instructional methods are needed to maintain airway providers’ skills.

Dear Editor,

We read the article titled ‘Involving stakeholders in re-imagining a medical curriculum’ (Foster, 2022) with great interest. We would like to share our experiences and extend the importance of stakeholder involvement in postgraduate health professions education programmes (PGHPE). These programmes are utilised by educators for skills development, career progressions and advancement of health professions education across various health professions. Our institution started accredited PGHPE programmes in 2018 to equip health professional educators within and outside our institution with competencies to deliver evidence-based education and impact graduate outcomes positively. Our curriculum review conducted in early 2023, began with a stakeholder engagement meeting involving students, facilitators, alumni, employers, and ‘institutional partners’ (national and international HPE experts). Focus group discussions were held on four areas: (1) HPE ‘Industry’ institutional Needs and Graduate Competencies, (2) Student Experience, (3) Scholarship in HPE, and (4) Inter-Institutional Partnership and Collaboration.

I. INTRODUCTION

There is growing interest in social responsibility around the world in order to accomplish a sustainable society. Indeed, modern universities cannot be ivory towers unrelated to society. It would not be an overstatement to say that without interaction and contribution to society, the university’s survival and development are unlikely.

It is frequently said that the university fulfils three different missions: education, research, and social contribution. J. A. Perkins, the eminent theoretician of higher education in the 1960s, proposed there are three aspects of knowledge that must be understood as they have their institutional reflections in the university’s three missions (Perkins, 2016). For knowledge itself to have significant power, there must be communication and interaction between the newly acquired knowledge, its transmission, and its application. The above concept began in the United States and has since been widely adopted as three major missions in many universities worldwide. Despite these three missions, however, depending on the university’s expertise and readiness, and the resources and support received from external organisations and individuals, the university may be more active on some missions and less active on others.

I. TO BEGIN WITH MY VIEW

Medical education is a social science which addresses how people learn and teach medicine. The practice of education and training is therefore fundamental to its epistemology, whereby knowledge, and so scholarship, derives from practice. Where that practice is subject to social, contextual and cultural factors, we must question whether the tenets that are put forward are generalisable beyond the context from which they were derived (Fendler & Cole, 2006). This lack of automatic generalisability has implications for both the scholarship of the medical educationalist, and for the relationship between medical educationalist and teacher. Where educational practice is primary, and is contextually informed, then the teacher, the practitioner of medical education, must be the leader in developing scholarship, while the medical educationalist can support that development by enabling each teacher, context or culture, to tell their own truth well (Grant & Grant, 2022). 

I. INTRODUCTION

Anatomy is considered as one of the key components of undergraduate medical education. Hence, it is important to have a sound knowledge in anatomy to proceed into clinical medicine. Didactic lectures, textbooks, prosected specimens, and cadaveric dissection are the most frequently used anatomy teaching methods. However, with the emergence of COVID-19 pandemic, conventional teaching and learning were challenged. Technology integration for medical education has been increased during COVID-19 in many countries. With the integration of new technologies to the anatomy teaching, the traditional ‘directed self-learning’ started to move towards ‘self-directed learning’. This transformation however, was not without various challenges, especially in low-resource settings such as Sri Lanka (Karunathilake et al., 2020). Augmented reality (AR), Virtual reality (VR), and principles of gamification play an important role in motivation and engagement in medical teaching and learning by enhancing interactivity (Moro et al., 2021). Such technologies also found to have positive impact on students’ spatial understanding and 3D comprehension of anatomical structures.

I. INTRODUCTION

The ongoing COVID-19 pandemic has a significant impact on medical education, forcing changes in the curriculum　(Rose, 2020). Since the COVID-19 pandemic began, governments and authorities in many countries have imposed online learning on medical students and in many institutions, medical students were not permitted to participate in in-person clinical clerkships or other practical training at university hospitals (Mian & Khan, 2020). Although the surgical clerkship is an important contributing factor to nurture student interest in a surgical career (Khan & Mian, 2020), medical students were excluded from the operating room due to lack of personal protective equipment, and participation in ward duties and training facilities were restricted (Calhoun, et al., 2020).

The purpose of this study is to analyse how the lack of in-person surgical experience and ward duties (online clerkship), among the most important components of a surgical clerkship, affected student interest in a career in surgery. The impact on student perceptions of surgery comparing online learning and onsite clinical clerkship (typical in-person clerkship) was assessed by comparing student satisfaction with the surgical clerkship, changes in interest in a career in surgery, and changes in the image of surgery at the beginning and end of rotations for online and onsite training groups.

Dear Editor,

I read with great interest the article entitled “The associates of Emotional Intelligence in medical students: A systematic review” (Edussuriya et al., 2022) in your journal published in October 2022. The association of Emotional Intelligence (EI) with wellbeing cannot be underestimated, especially with the plethora of positive effects it has on mental health and academic performance. In fact, I think this can be extended beyond students, to all healthcare professionals.

I. INTRODUCTION

Interactive oral assessment has been identified as a form of authentic assessment that enables students to develop their professional identity, communications skills, and helps promote employability (Sotiriadou et al., 2020). It simulates authentic scenarios where assessors can engage students in genuine and unscripted interactions that represents workplace experiences (Sotiriadou et al., 2020). Unlike written examinations, interactive oral questions are not rigidly standardised as students and assessors role-play using workplace scenarios, enabling students to respond to the conversational flow and achieve authenticity (Tan et al., 2021). Using Villarroel et al. (2018) four-step ‘Model to Build Authentic Assessment’, this paper will present the use of oral interactive with first year occupational therapy students. This is within the context of a module named “Occupational Performance Across Lifespan” and students learn about children’s developmental milestones.

Medication errors are one of the most serious problems in healthcare, and their occurrence is due to a wide variety of causes. While almost all drug-related medical errors are potentially avoidable, the main obstacles are primarily health system vulnerabilities and human error. To remove those obstacles, the World Health Organization (WHO) suggested providing more education (World Health Organization, 2017), specifically by participating in medical care. Graduation competencies in many countries, which include activities about medication and patient safety, are consistent with the statement. In addition, it is known that more prescribing errors occur in the first postgraduate year. Learning about prescriptions during medical studentships must be enhanced.

I. INTRODUCTION

For safe practice of medicine, proficiency in anatomy is important. Anatomy is mainly taught in the pre-clinical years. Knowledge retention decreases over time and this will affect clinical and practical application during clinical years (Jurjus et al., 2014; Zumwalt et al., 2007). Literature shows that integrating relevant anatomy with clinical teaching will reinforce the basic concepts and fill these knowledge gaps. Rajan et al. (2016) in their study show that integrating neuroanatomy refresher sessions to clinical neurological case discussions was effective in building relevant knowledge.

I. INTRODUCTION

Singapore raised its Disease Outbreak Response System Condition (DORSCON) from yellow to orange on the 7^th of February 2020 after it is first reported unlinked community COVID-19 case on the 6^th of February 2020.

The Department of Emergency Medicine (DEM) of Singapore General Hospital (SGH) hosted clinical rotations for medical students (MS) from Duke-NUS Medical School. Their clinical rotations lasted four weeks, during which MS were expected to achieve competence in history taking, physical examination, formulating a management plan, and performing minor procedures.

The local curriculum relies heavily on clinical rotations, during which MS directly contacts patients to fulfil their learning objectives. During DO, clinical postings were postponed, and the term break was brought forward (Ashokka et al., 2020). Restricting MS from entering hospitals and having face-to-face interactions with patients resulted in significant changes to clinical learning. Learning sessions involving direct contact that could not be held over remote platforms were cancelled.

We aimed to discover how MS felt excluded from clinical teaching during the COVID-19 pandemic and how teaching could be improved to support their learning.